Full Text of HB0517 095th General Assembly
HB0517enr 95TH GENERAL ASSEMBLY
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| AN ACT concerning long-term care.
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| Be it enacted by the People of the State of Illinois,
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| represented in the General Assembly:
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| Section 1. Short title. This Act may be cited as the | 5 |
| Illinois Long-Term Care Partnership Program Act. | 6 |
| Section 5. Findings. The General Assembly finds that our | 7 |
| nation's current financing structure relies too heavily on | 8 |
| individuals and families to bear the financial burden of | 9 |
| long-term supportive services. The financial burden can be so | 10 |
| large that, for many individuals, particularly those with | 11 |
| moderate income, the only alternative is Medicaid, which | 12 |
| requires spending down all assets in order to qualify to | 13 |
| receive long-term care benefits. | 14 |
| The General Assembly declares that Medicare is not intended | 15 |
| to cover the majority of long-term care expenses. Medicaid is | 16 |
| the largest source of funding for long-term care in the United | 17 |
| States, making the financing of long-term care costs a | 18 |
| significant issue for both State and federal budgets. The | 19 |
| growth in spending by the federal government and states for | 20 |
| long-term care services through Medicaid will continue to | 21 |
| increase as the American population ages. | 22 |
| The General Assembly finds that one solution to help | 23 |
| address the spiraling Medicaid growth and encourage |
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| individuals to plan for their long-term care is the Long Term | 2 |
| Care Partnership Program, a public-private partnership between | 3 |
| states and private insurance companies. It is the intent of | 4 |
| this program to reduce future Medicaid costs for long-term care | 5 |
| by delaying or eliminating dependence on Medicaid by providing | 6 |
| incentives for individuals to insure against the cost of | 7 |
| providing for their long-term care needs. The program, | 8 |
| including the treatment of assets for Medicaid eligibility and | 9 |
| estate recovery, shall be structured and administered in | 10 |
| accordance with federal law and applicable federal guidelines.
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| Section 10. Definitions. As used in this Act: | 12 |
| "Agency" means the Department of Healthcare and Family | 13 |
| Services. | 14 |
| "Asset disregard" means, with respect to qualification for | 15 |
| State Medicaid benefits, the
disregard of any assets or | 16 |
| resources in an amount equal to the insurance benefit payments | 17 |
| that are made to or on the behalf of an individual who is a | 18 |
| beneficiary under a qualified long-term care insurance | 19 |
| partnership policy. | 20 |
| "Department" means the Department of Financial and | 21 |
| Professional Regulation. | 22 |
| "Medicaid" means the federal medical assistance program | 23 |
| established under Title XIX
of the Social Security Act.
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| "Qualified long-term care insurance partnership policy" | 25 |
| means a policy that meets all of the following requirements: |
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| (1) it covers an insured who was a resident of Illinois | 2 |
| when coverage first became effective under the policy;
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| (2) it is a qualified long-term care insurance policy | 4 |
| as defined in Section 7702B(b) of the Internal Revenue Code | 5 |
| of 1986 issued not earlier than the effective date of the | 6 |
| State plan amendment;
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| (3) it meets the model regulations and requirements of | 8 |
| the National Association of Insurance Commissioners model | 9 |
| specified in paragraph (5) of Title VI, Section 6021 of the | 10 |
| federal Deficit Reduction Act of 2005, and the Director of | 11 |
| the Division of Insurance of the Department certifies it as | 12 |
| meeting these requirements; and | 13 |
| (4) if the policy is sold to an individual who:
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| (A) has not attained age 61 as of the date of | 15 |
| purchase, the policy provides compound annual | 16 |
| inflation protection;
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| (B) has attained age 61 but has not attained age 76 | 18 |
| as of such date, the policy provides some level of | 19 |
| inflation protection; or | 20 |
| (C) has attained age 76 as of such date, the policy | 21 |
| may, but is not required to, provide some level of | 22 |
| inflation protection.
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| "State plan amendment" means a State Medicaid plan | 24 |
| amendment made to the federal
Department of Health and Human | 25 |
| Services that provides for the disregard of any assets or | 26 |
| resources in an amount equal to the insurance benefit payments |
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| that are made to or on the behalf of an individual who is a | 2 |
| beneficiary under a qualified long-term care insurance | 3 |
| partnership policy.
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| Section 15. Illinois Long-term Care Partnership Program. | 5 |
| (a) In accordance with Title VI, Section 6021 of the | 6 |
| federal Deficit Reduction Act of 2005, there shall be | 7 |
| established the Illinois Long-Term Care Partnership Program, | 8 |
| to be administered by the Agency with the assistance of the | 9 |
| Department to do the following:
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| (1) provide incentives for individuals to insure | 11 |
| against the costs of providing for their long-term care | 12 |
| needs;
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| (2) provide a mechanism for individuals to qualify for | 14 |
| coverage of the cost of their long-term care needs under | 15 |
| Medicaid without first being required to substantially | 16 |
| exhaust their resources;
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| (3) provide counseling services to individuals | 18 |
| planning for their long-term care needs; and
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| (4) alleviate the financial burden on the State's | 20 |
| medical assistance program by encouraging the pursuit of | 21 |
| private initiatives.
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| (b) The Agency shall:
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| (1) Within 180 days of the effective date of this Act, | 24 |
| or as soon thereafter as possible, make application to the | 25 |
| federal Department of Health and Human Services for a State |
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| plan amendment to establish that, if an individual is a | 2 |
| beneficiary of a long-term care partnership program | 3 |
| certified policy, the total assets an individual owns and | 4 |
| may retain under Medicaid and still qualify for benefits | 5 |
| under Medicaid at the time the individual applies for | 6 |
| long-term care benefits are increased by $1 for each $1 of | 7 |
| benefit paid out under the individual's long-term care | 8 |
| partnership program certified insurance policy.
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| (2) Provide information and technical assistance to | 10 |
| the Department on the Department's role in assuring that | 11 |
| any individual who sells a qualified long-term care | 12 |
| insurance partnership policy receives training and | 13 |
| demonstrates evidence of an understanding of such policies | 14 |
| and how they relate to other public and private coverage of | 15 |
| long-term care. | 16 |
| (c) The Department may not impose any requirement affecting | 17 |
| the terms or benefits of qualified long-term care partnership | 18 |
| policies unless the Department imposes the requirement on all | 19 |
| long-term care policies sold in Illinois without regard to | 20 |
| whether the policy is covered under the partnership or is | 21 |
| offered in connection with the partnership.
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| (d) The issuers of qualified long-term care partnership | 23 |
| policies in Illinois shall provide regular reports to the | 24 |
| Secretary of the federal Department of Health and Human | 25 |
| Services, in accordance with federal regulation. Issuers of | 26 |
| qualified long-term care partnership policies in Illinois |
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| shall provide appropriate reports to the Agency and to the | 2 |
| Department as determined by those entities. | 3 |
| Section 20. Administration. | 4 |
| (a) The Agency and the Department are authorized to adopt | 5 |
| regulations to implement the provisions of this Act and rules | 6 |
| for its administration. | 7 |
| (b) The Agency and Department must comply with all federal | 8 |
| rules developed in accordance with Title VI, Section 6021 of | 9 |
| the federal Deficit Reduction Act of 2005, regarding data | 10 |
| reporting, reciprocity with other states that develop | 11 |
| long-term care insurance partnership programs, and any other | 12 |
| matters, and shall have the authority to adopt regulations | 13 |
| relative to the provisions of any federal rules and their | 14 |
| administration.
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| (320 ILCS 35/Act rep.)
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| Section 25. The Partnership for Long-Term Care Act is | 17 |
| repealed.
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| Section 99. Effective date. This Act takes effect upon | 19 |
| becoming law.
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